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小脑在吞咽中的作用。

The Role of the Cerebellum in Swallowing.

机构信息

Gastrointestinal (GI) Sciences, Faculty of Biology, Medicine and Health, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), Salford, UK.

出版信息

Dysphagia. 2023 Apr;38(2):497-509. doi: 10.1007/s00455-021-10271-x. Epub 2021 Mar 6.


DOI:10.1007/s00455-021-10271-x
PMID:33675425
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10006062/
Abstract

Swallowing is a complex activity requiring a sophisticated system of neurological control from neurones within the brainstem, cerebral cortices and cerebellum. The cerebellum is a critical part of the brain responsible for the modulation of movements. It receives input from motor cortical and sensory areas and fine tunes these inputs to produce coordinated motor outputs. With respect to swallowing, numerous functional imaging studies have demonstrated increased activity in the cerebellum during the task of swallowing and damage to the cerebellum following differing pathological processes is associated with dysphagia. Single pulses of transcranial magnetic stimulation (TMS) have been applied to the cerebellum and have been shown to evoke motor responses in the pharynx. Moreover, repetitive TMS (rTMS) over the cerebellum can modulate cerebral motor (pharyngeal) cortical activity. Neurostimulation has allowed a better understanding of the connections that exist between the cerebellum and cerebral swallowing motor areas in health and provides a potential treatment for neurogenic dysphagia in illness. In this review we will examine what is currently known about the role of the cerebellum in the control of swallowing, explore new findings from neurostimulatory and imaging studies and provide an overview of the future clinical applications of cerebellar stimulation for treating dysphagia.

摘要

吞咽是一项复杂的活动,需要来自脑干、大脑皮层和小脑的神经元的复杂神经系统控制。小脑是大脑中负责调节运动的关键部分。它接收来自运动皮质和感觉区域的输入,并对这些输入进行微调,以产生协调的运动输出。在吞咽方面,许多功能成像研究表明,在吞咽任务期间小脑活动增加,并且在不同的病理过程之后小脑损伤与吞咽困难有关。小脑的单次经颅磁刺激 (TMS) 已被应用于小脑,并已证明可以在咽部引起运动反应。此外,小脑的重复 TMS (rTMS) 可以调节大脑运动(咽部)皮质活动。神经刺激使我们更好地了解了小脑与健康时的大脑吞咽运动区域之间的联系,并为疾病中的神经源性吞咽困难提供了一种潜在的治疗方法。在这篇综述中,我们将探讨小脑在吞咽控制中的作用的现有知识,探索神经刺激和成像研究的新发现,并概述小脑刺激治疗吞咽困难的未来临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/95ef4e6d74c0/455_2021_10271_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/df0138481969/455_2021_10271_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/b3a55b785956/455_2021_10271_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/d395700dcd04/455_2021_10271_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/fcdbd4b24e49/455_2021_10271_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/95ef4e6d74c0/455_2021_10271_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/df0138481969/455_2021_10271_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/b3a55b785956/455_2021_10271_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/d395700dcd04/455_2021_10271_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/fcdbd4b24e49/455_2021_10271_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1832/10006062/95ef4e6d74c0/455_2021_10271_Fig5_HTML.jpg

相似文献

[1]
The Role of the Cerebellum in Swallowing.

Dysphagia. 2023-4

[2]
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[3]
Non-invasive magnetic stimulation of the human cerebellum facilitates cortico-bulbar projections in the swallowing motor system.

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[4]
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[5]
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J Physiol. 2019-4-3

[6]
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Neural Plast. 2022

[7]
The effects of unilateral and bilateral cerebellar rTMS on human pharyngeal motor cortical activity and swallowing behavior.

Exp Brain Res. 2020-8

[8]
Repetitive Transcranial Magnetic Stimulation on Individualized Spots Based on Task functional Magnetic Resonance Imaging Improves Swallowing Function in Poststroke Dysphagia.

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[9]
Rapid improvement in brain and swallowing behavior induced by cerebellar repetitive transcranial magnetic stimulation in poststroke dysphagia: A single patient case-controlled study.

Neurogastroenterol Motil. 2019-4-26

[10]
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引用本文的文献

[1]
Expiratory Musculature Targeted Resistance Training Modulates Neural Connections During Swallowing Tasks: Preliminary fMRI Evidence.

Neural Plast. 2025-8-6

[2]
Morphological analysis and functional connectivity of the insular in patients with dysphagia after cerebral infarction based on resting-state fMRI.

BMC Neurol. 2025-7-30

[3]
Purkinje cells of the cerebellum control deceleration of tongue movements.

PLoS Biol. 2025-4-10

[4]
Feasibility of Cerebellar Stimulation for the Treatment of Post-Stroke Dysphagia.

Cerebellum. 2025-3-26

[5]
Determination of oral feeding skills in late preterm, early term, and full-term infants using the neonatal oral feeding monitor (NeoSAFE).

Ital J Pediatr. 2025-2-7

[6]
Control of tongue movements by the Purkinje cells of the cerebellum.

bioRxiv. 2025-2-14

[7]
Relationship Between DWI-Based Acute Ischemic Stroke Volume, Location and Severity of Dysphagia.

Brain Sci. 2024-11-26

[8]
Study on the predictive value of APACHE II score and neurogenic dysphagia in carbapenem-resistant Klebsiella pneumoniae.

Medicine (Baltimore). 2024-12-13

[9]
Every bite counts to achieve oral health: a scoping review on diet and oral health preventive practices.

Int J Equity Health. 2024-12-2

[10]
Revealing Goal-Directed Neural Control of the Pharyngeal Phase of Swallowing.

Dysphagia. 2024-10-10

本文引用的文献

[1]
The Effects of Midline Cerebellar rTMS on Human Pharyngeal Cortical Activity in the Intact Swallowing Motor System.

Cerebellum. 2021-2

[2]
Functional architecture of the motor homunculus detected by electrostimulation.

J Physiol. 2020-12

[3]
The effects of unilateral and bilateral cerebellar rTMS on human pharyngeal motor cortical activity and swallowing behavior.

Exp Brain Res. 2020-8

[4]
Dysphagia Affecting Quality of Life in Cerebellar Ataxia-a Large Survey.

Cerebellum. 2020-6

[5]
Whole-body somatotopic maps in the cerebellum revealed with 7T fMRI.

Neuroimage. 2020-5-1

[6]
Progressive Supranuclear Palsy with Predominant Cerebellar Ataxia.

J Mov Disord. 2020-1

[7]
Dysphagia in Progressive Supranuclear Palsy.

Dysphagia. 2020-8

[8]
Lesion location and other predictive factors of dysphagia and its complications in acute stroke.

Clin Nutr ESPEN. 2019-10

[9]
Rapid improvement in brain and swallowing behavior induced by cerebellar repetitive transcranial magnetic stimulation in poststroke dysphagia: A single patient case-controlled study.

Neurogastroenterol Motil. 2019-4-26

[10]
Cerebellar repetitive transcranial magnetic stimulation restores pharyngeal brain activity and swallowing behaviour after disruption by a cortical virtual lesion.

J Physiol. 2019-4-3

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